title: Prevalence of secondary causes of bone loss among breast cancer patients with osteopenia and osteoporosis.
abstract: OBJECTIVE
  To determine the prevalence of secondary causes of bone loss among patients with breast cancer with osteopenia and osteoporosis.
  
  
  METHODS
  All women referred to a bone health clinic over a 6-year period for bone evaluation were included in this retrospective study and stratified based on presence or absence of a breast cancer history. The prevalence of secondary causes of bone loss in the two groups was compared.
  
  
  RESULTS
  Of the 238 women identified, 64 women had breast cancer. The non-breast cancer group (n = 174) was significantly older (P = .015), had a lower mean weight (P = .019), lower 25 hydroxy-vitamin D level (P = .019), and greater degree of bone loss in both the spine and hip (P < .001 and 0.004, respectively). The presence of at least one secondary cause of bone loss, excluding cancer-related therapies, was seen in 78% of the breast cancer patient group and in 77% of the non-breast cancer group (P = not significant). Newly diagnosed metabolic bone disorders were seen in 58% of the breast cancer population. The most common was vitamin D deficiency, seen in 38% of patients in the breast cancer group and 51% of patients in the non-breast cancer group. Idiopathic hypercalciuria was diagnosed in 15.6%, primary hyperparathyroidism in 1.6%, and normocalcemic hyperparathyroidism in 3.1% of the breast cancer population.
  
  
  CONCLUSIONS
  A high prevalence of secondary causes of bone loss among patients with breast cancer supports a comprehensive evaluation in these patients, particularly those considering therapy with an aromatase inhibitor.
authors.affiliation: Division of Endocrinology and Metabolism, Hematology/Oncology Institute, Department of Medicine, Loyola University Medical Center, Maywood, IL 60153, USA. pcamach@lumc.edu
authors.forename: Pauline M
authors.initials: PM
authors.lastname: Camacho
authors.forename: Amit S
authors.initials: AS
authors.lastname: Dayal
authors.forename: Josefina L
authors.initials: JL
authors.lastname: Diaz
authors.forename: Fadi A
authors.initials: FA
authors.lastname: Nabhan
authors.forename: Monica
authors.initials: M
authors.lastname: Agarwal
authors.forename: John G
authors.initials: JG
authors.lastname: Norton
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Robinson
authors.forename: Kathy S
authors.initials: KS
authors.lastname: Albain
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000209:etiology*
chemical_list: D000970:Antineoplastic Agents; D047072:Aromatase Inhibitors